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New Arizona Law Restricts Access to a Range of Reproductive Health Services

First published online: July 16, 2009

On July 13, Arizona Gov. Jan Brewer signed into law a measure that establishes—among other restrictions on access to sexual and reproductive health services—an in-person counseling requirement and a 24-hour waiting period before a woman can obtain an abortion. Proponents of the new law claim that it helps inform women’s abortion decisions. In truth, however, this distortion of the informed consent process only hinders access to abortion services.

The real impact of policies requiring a 24-hour delay between in-person counseling and the abortion procedure—that is, two visits in two days—is to force women to take more time off from work, arrange additional child care or stay away from home overnight when the distance to the clinic is great. Several studies conducted in Mississippi consistently found that an in-person counseling requirement was associated with more abortions’ being obtained out-of-state and more being performed during the second trimester.

Other Guttmacher studies have shown that disadvantaged women who have trouble raising the funds for their abortion frequently take up to three weeks longer than better-off women to obtain an abortion and have greater difficulties arranging the logistics—time off work, child care and transportation—to obtain the procedure. A requirement of multiple visits imposes even more barriers for these vulnerable women.

Moreover, laws like Arizona’s that mandate waiting periods are premised on the false notion that women seeking an abortion often have not made a carefully considered decision and would benefit from more information and more time. However, abortion providers report that almost all women are sure of their decision before picking up the phone to make an appointment. And the reasons women express for deciding to have an abortion make it clear that they carefully consider the realities of their lives and their ability to be the kind of parents they want to be to their current and future children. Six in 10 women who obtain an abortion are already parents. For them, the issue of caring for dependents is not an abstract one, but a reflection of their current lives.

Arizona’s new law also significantly expands the right of health care providers and institutions to refuse to render services to which they object on religious or moral grounds. Physicians, nurses, pharmacists, pharmacies and medical facilities may now refuse to provide a range of birth control methods (such as IUDs, emergency contraception and even regular birth control pills) that they claim to be abortifacients, but that are both medically and legally designated as contraceptives. Moreover, the Arizona law fails to strike an appropriate balance by not protecting the patient’s needs. For instance, the law has no provision ensuring that patients who are refused emergency contraception can obtain the medical care they need from other sources.

This expansive right to refuse services will likely result in some women’s not being able to obtain and use emergency contraception in a timely fashion, and may well result in more unintended pregnancies and abortions. Emergency contraception is critical in helping women ensure that a contraceptive lapse or failure does not lead to an unintended pregnancy. It can help prevent pregnancy when taken up to 120 hours after unprotected sex, although the sooner it is taken, the more effective it is.

The far-ranging new law also stipulates that only physicians be allowed to perform abortions (nurses had previously been allowed to perform the procedure for women who were up to 12 weeks pregnant). It also adds a cumbersome requirement that parents’ consent for a minor’s abortion be notarized and outlines strict criteria for judges to use when considering if a minor may obtain an abortion without parental consent.

In sum, Arizona has simply made it more difficult for women to obtain the reproductive health services—including abortion and emergency contraception—they need. The evidence is clear: Coercive laws (like those mandating in-person counseling and waiting periods) and additional barriers to obtaining abortions and contraceptives will do nothing to improve Arizona women’s health.

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